Ovulation Induction and Ovarian Malignancy

Beltsos, Angeline; Odem, Randall R.

doi:10.1055/s-2008-1067981

Cited by 9 publications

(6 citation statements)

References 22 publications

(28 reference statements)

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“…Some historical as well as more recent cohort studies showed an increased risk of ovarian cancer with the use of infertility treatment, such as CC and gonadotrophins . This led some reviewers to conclude that the risk of ovarian cancer, if such a risk exists, is two to three times higher than the risk for the general population, with the lifetime risk of ovarian cancer in the general population quoted at 1 in 70 (~1.43%); thus, an equivalent risk for patients treated with fertility drugs may carry a 4–5% lifetime risk …”

Section: Fertility Treatment and Ovarian Cancermentioning

confidence: 99%

“…16 This led some reviewers to conclude that the risk of ovarian cancer, if such a risk exists, is two to three times higher than the risk for the general population, with the lifetime risk of ovarian cancer in the general population quoted at 1 in 70 (~1.43%) 17 ; thus, an equivalent risk for patients treated with fertility drugs may carry a 4-5% lifetime risk. 18 The paper by Rossing et al 15 in 1994 led to significant change in practice regarding the use of CC, as it concluded that the latter increased the risk of borderline and invasive ovarian cancer. This was even more so when CC was taken for 12 or more cycles with a relative risk (RR) of 2.3 in general and 11.1 (with 12 or more cycles) compared with infertile women with no CC use (95% CI 0.5-11.4 and 1.5-82.3 respectively).…”

Section: Ethical Issues Introductionmentioning

confidence: 99%

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The relationship between infertility treatment and cancer including gynaecological cancers

Louis

Saso

Ghaem‐Maghami

et al. 2013

The Obstetric & Gynaecologis

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Key content Increasing availability and expanding usage of infertility treatment is a concern with regard to a possible increase in the risk of future malignancy development for women and their offspring. Infertile women are at significantly increased risk of developing ovarian and uterine cancers, especially nulliparous women. Earlier studies pointed to a possible increase in the risk of ovarian cancer following large doses and multiple cycles of clomiphene citrate. Recent studies did not observe any increase in malignancy risk due to infertility medications. Other confounding factors, such as infertility itself, may well be the reason for the increased percentage of cancer cases noted in earlier studies. Uterine cancer risk is possibly increased following multiple cycles and high doses of clomiphene citrate. There is no strong evidence linking infertility treatment with non‐gynaecological or childhood cancers, with the possible exception of melanoma. Learning objectives To highlight the available evidence linking infertility treatment with gynaecological, non‐gynaecological and childhood cancers. How to counsel women about any possible risk of future neoplasia after infertility treatment. Ethical issues Is it ethical to persevere with multiple fertility treatment cycles if it might be associated with increased risk of neoplasia in the future?

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Section: Fertility Treatment and Ovarian Cancermentioning

confidence: 99%

Section: Ethical Issues Introductionmentioning

confidence: 99%

The relationship between infertility treatment and cancer including gynaecological cancers

Louis

Saso

Ghaem‐Maghami

et al. 2013

The Obstetric & Gynaecologis

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“…Accordingly, the risk for women for the development of ovarial cancer under an increased ovarian activity caused by ovulation stimulating pharmaceutical therapy rises about 100% compared with the risk of women without such a medication. (181,4,19,67) Following conclusion can be derived from that: The commitment of pharmaceuticals in the therapy of infertility, which increases the number of ovulations can lead directly to an increased risk for ovarial cancer. The hazard for the development of a malignant tumor with a low malignant potential lies at 143% (18).…”

Section: Womens' Risksmentioning

confidence: 99%

“…These reports are published in all sides known journals as for example Human Reproduction. Facts on ART are presented to the public in almost every European country; however, they are hardly mentioned in Croatia (1,2,3,4,5,6,7,8,9,10,11,12,14,15,16,17,18,19,20,21,22).…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Fertilization in the World and in Croatia

Buković

Segregur²,

Radan³

et al. 2011

Med Arh

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a im: To point out the dangers, side effects and risks of medical assisted fertilization, in vitro fertilization, embryo transfer and injection on sperm in ovum for mother and the child. Results: On the one hand the negative side effects for women of an abrupt rising risk for the development of neoplasm under pharmaceutical therapy are mentioned. Especially under a therapy which has the purpose to stimulate the ovulation of the ovary it lies around 100%. An increased level of certain hormones, as for example HCG, which influences the ovulation, is closely related with the risk of developing ovarian cancer. Clinical studies at more than 12000 infertile women (primary and secondary acyesis), with an average age of 30 years, show an elevated risk for the development of a malignant tumor of 98%. Also the application of Gonadotrophin is connected with a risk of 146% for the occurrence of cancer after a period of 15 years. FDT involves a risk of about 12% for the occurrence of breast cancer and shows also an aggravation for the risk of cancer of the endometrium from 79% up to 1152%. On the other hand the risk of spontaneous miscarriages under MAF, which is near 20%, and serious illness of the children, including 47% with need of intensive care unit support after birth, need to be realized. Furthermore the investigation of naturally obtained twins and through ART obtained twins shows in the arrangement a slower and poorer development of the children in the ART group with also great differences in physical development. In total the number of inherent malformation of newborns under the use of ART rises from 47 to 177 %. With an installment of 9% we notice that children who came into being by IVF and ICS also fall more frequently ill. (Teething troubles, more hospitalizations and operations, higher frequency of major inherent malformations). Conclusion: All women who want to undergo a medical assisted fertilization should be informed about the side effects and risks for mother and child.

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“…Several hypotheses about the etiology of ovarian cancer have been proposed. “Gonadotropin hypothesis” states that increased exposure to the gonadotropins, follicle stimulating hormone (FSH) and lutenizing hormone (LH), leads to ovarian surface epithelium (OSE) transformation [20] which is supported by evidence that as women enter menopause, their levels of FSH and LH are very high, which corresponds with the age that most women develop ovarian cancer [21]. “Tubal hypothesis” has emerged which proposes that ovarian cancer may not originate from the ovary at all, but rather arises from the oviduct [22,23] in a way that Fallopian tube exposure to the same microenvironment as the ovary which contains many inflammatory factors may potentially damage OSE and induce mutation and transformation.…”

Section: Introductionmentioning

confidence: 99%

Age dependent increase in prostaglandin pathway coincides with onset of ovarian cancer in laying hens

Eilati

Pan

Bahr

et al. 2012

Prostaglandins, Leukotrienes and Essential Fatty Acids

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Chronic inflammation has been linked to cancer. Prostaglandin E2 (PGE2) is the most pro-inflammatory lipid and one of the downstream products of 2 isoforms of cyclooxygenase (COX) enzymes: COX-1 and COX-2. Ovarian cancer is the most lethal gynecological malignancy and mainly occurs in older women. The factors that contribute to the correlation of age and ovarian cancer are unknown. The purpose of this study was to examine the expression of COX enzymes and PGE2 levels in ovaries and correlate them to ovarian cancer and aging. White Leghorn hens aged 1, 1.5, 2, 2.5, 3 and 3.5 years were used. The incidence of ovarian cancer was determined by gross pathology and histology. COX-1 and COX-2 protein and mRNA expression and PGE2 concentrations in ovaries were measured using Western blot, quantitative real-time PCR and ELISA, respectively. Our results indicated an increase in ovarian cancer incidence and expression of both COX enzymes in ovaries of older hens. In correlation with ovarian cancer incidence and COX enzymes expression, PGE2 concentrations were elevated with age. Ovaries with tumor had elevated COX-1 expression and PGE2 concentration compared to normal ovaries. Our findings suggest that the up-regulation of COX enzymes with age is the main contributing factor in the age associated increase in PGE2. Furthermore, elevated PGE2 in ovaries of hens concomitant with age suggests its important role in early stages of ovarian carcinogenesis. These finding may provide the basis for clinical trials utilizing COX specific inhibitors or dietary intervention targeting prostaglandin biosynthesis for the prevention and treatment of ovarian cancer.

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Ovulation Induction and Ovarian Malignancy

Cited by 9 publications

References 22 publications

The relationship between infertility treatment and cancer including gynaecological cancers

The relationship between infertility treatment and cancer including gynaecological cancers

Extracorporeal Fertilization in the World and in Croatia

Age dependent increase in prostaglandin pathway coincides with onset of ovarian cancer in laying hens

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